It’s just a simple sprain. You baby it for a few days, and then you’re good to go, right? Not necessarily! When you sprain your ankle, the ligaments around the bones receive varying degrees of damage, but tendons in the area may also be involved, and you could end up with a secondary issue. You might not recognize the term peroneal tendonitis, but you’ll certainly recognize the pain that goes with it!
Where Are These Tendons, Exactly?
The peroneal muscles run along your fibula—the long bone on the outer (lateral) side of your lower leg. They attach to their corresponding tendons, which run down behind your ankle bone (actually the widened end of the fibula) and attach to the bones in your forefoot to help pull your foot downward. They are held in place behind the ankle bone by a fiber sheath called the retinaculum, much as the adjustable seat belt holder by your car door holds the belt away from your neck.
Why Do Peroneal Tendons Hurt?
These tissues hurt when they are damaged, which can occur in several ways. The sprain we mentioned is one instance. When the foot rolls too far, the tendon is forcefully stretched and can develop a lengthwise tear. It can also slip out of position for a moment (called subluxation). Because the ligaments are damaged, the tendons may have to work harder to keep your ankle stable, and the extra stress can harm them. Having high arches also increases the stress on them. All of these conditions can cause that familiar pain along the outer edge of your foot behind your ankle.
Damage can also accumulate as you engage in physical activity. Each time your foot moves, these connectors glide back and forth between the retinaculum and the ligaments of your ankle joint. This is multiplied thousands of times when you run long distances, play basketball for an hour, or do an 8 to 12-hour shift on your feet.
Irritation can develop in the lining of the tendon, or the collagen fibers can lose their connections and become tangled or break. Over time, scar tissue develops, and gradually the tissue weakens and degenerates. The result is inflammation and discomfort. The area behind the ankle bone can swell and be tender to the touch, and the ankle may feel unstable. Pain is felt while you are using your foot; it may go away while you are resting and then return again with activity.
How to Treat Peroneal Tendonitis
Dr. Robert Parker is an experienced podiatrist who can often tell what part of the tendon is damaged with just a physical examination of your foot. However, we may want x-rays to make sure no bones are broken or an MRI to identify the extent of soft tissue damage.
Our hope is always to heal your feet and get you back to normal activity with conservative treatments. These will include some combination of rest, immobilization with a cast or splint, medication, physical therapy, and bracing during activity to support the joint.
If you allow your body the time it needs to heal and regenerate these tissues, conservative methods are often enough to relieve your pain and inflammation and allow you to resume your normal life. In some cases, however, surgery may be needed to repair extensive tendon damage. If this is the case, we will fully discuss the reasons and the procedure itself, as well as what you can expect during recovery.
Pain behind your ankle should not be ignored or “waited out” as it could lead to further damage if not healed properly now. Please call Parker Foot & Ankle if you have sprained your ankle and symptoms are not starting to improve in a day or two. An appointment at our Houston office may be the difference between a fully stable joint that allows you to continue to work and play as usual, or a life of chronic problems in the future. Call us at (281) 497-2850 or schedule online today.